Business skills for nurses

April 13, 1993

Mention cost-effectiveness and health care in the same breath and you are likely to raise fears about cutting corners, rationing or a host of other bugaboos. But if this country is to achieve a sane, accessible health care system, it must find ways to increase the quality of care while holding down costs and increasing patient satisfaction. Who better to do that than the people who understand the nuts and bolts of delivering care?

The problem is that most health care providers have no training in the business side of medicine. The average physician spends many years in professional training without ever dealing with reimbursements or administrative matters. However, nursing schools have begun to recognize the value of giving students business training as well as the skills traditionally instilled in nurses.

The University of Maryland School of Nursing has joined forces with the University of Baltimore's Robert C. Merrick School of Business to offer a joint program in nursing and business, with degrees offered both at the masters and Ph.D. levels. The effort, now in its second year, is one of 32 such ventures around the country, and it represents the kind of interdisciplinary approach that will be needed to forge a new health care system.

Nurses with business training could have a significant effect on health care costs and outcomes. After all, nurses are often the key people in ensuring good care during hospital stays. They can see that patients get to scheduled tests on time and that tests are performed properly, thereby avoiding costly repeats. They have a great deal to say about what types of supplies are ordered, ranging from expensive monitoring equipment to the computer systems and software used to keep track of patients and their treatments.

Will business training turn nurses into penny-pinchers? On the contrary, it will enable them to participate in creating systems that make more sense and give better care.

An example: Why not structure hospitals so the support staff that patients need to see in any given day -- physical therapists, lab technicians, pharmaceutical aids, etc. -- can come to the patient, rather than shuttling patients all over a sprawling institution? Organizing hospitals for the benefit of patients rather than the convenience of staff could do wonders for patients, hastening healing and shortening hospital stays.

Giving nurses as well as other medical providers the ability to look at the broader context is one small but important step toward a health care system that is sensible and sane.